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General NPI Number Information
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NPI Number | 1780812768
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Entity Type | Organization
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Legal Business Name | AK-CHIROPRACTIC PC
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Dates
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Enumeration Date | 06/29/2009
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Last Update Date | 06/29/2009
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Provider Practice Location Address
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Address Line | 223 PICCADILLY DWNS
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City | LYNBROOK
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State | NY
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Zip | 11563-3145
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Country | US
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Telephone | 718-788-7007
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Fax |
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Provider Business Mailing Address
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Address Line | 223 PICCADILLY DWNS
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City | LYNBROOK
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State | NY
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Zip | 11563-3145
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ALEXANDER KHAVASH
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Credential | D.C.
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Telephone | 718-788-7007
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | X010592
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License Number State | NY
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